Effect of a Primary Care Walking Intervention with and without Nurse Support on Physical Activity Levels in 45-to 75-Year-Olds: The Pedometer And Consultation Evaluation (PACE-UP) Cluster Randomised Clinical Trial
Effect of a Primary Care Walking Intervention with and without Nurse Support on Physical Activity Levels in 45-to 75-Year-Olds: The Pedometer And Consultation Evaluation (PACE-UP) Cluster Randomised Clinical Trial
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DOI：
10.1371/journal.pmed.1002210
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发表时间：
2017-01-01
期刊：
影响因子：
15.8
通讯作者：
Cook, Derek G.
中科院分区：
文献类型：
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作者：
Harris, Tess;Kerry, Sally M.;Cook, Derek G.
背景计步器可以增加步行和中度到剧烈的身体活动（MVPA）水平，但它们的有效性与或没有支持没有严格的评估。我们评估的有效性，主要是不活跃的成年人，通过邮寄或通过初级保健护士支持的体力活动（PA）consultation.Methods和FindingsA平行三臂集群随机试验随机家庭，12个月的后续行动，在七个伦敦，英国，初级保健的做法。11，115例随机选择的年龄在45-75岁之间的无PA禁忌症的患者被邀请。排除了548名自我报告达到PA指南的患者。在2012-2013年期间，来自922个家庭的1023人被随机分配到以下组之一：常规护理（n = 338）;邮政计步器干预（n = 339）;护士支持的计步器干预（n = 346）。其中，956名参与者（93%）提供了结局数据（常规护理n = 323，邮政n = 312，护士支持n = 321）。两个干预组都接受了计步器，12周的步行计划和PA日记。护士组提供了三个PA咨询。主要和主要次要结局分别是通过加速度计客观测量的平均每日步数和MVPA时间（≥ 10分钟）从基线到12个月的变化。只有统计学家对分组设盲。平均基线日步数为7，479（标准差[s.d.] 2，671），MVPA发作的平均时间为94（s.d. 102)min/wk。12个月时，平均步数/d，s.d.括号内的数字如下：控制7 246（2 671）;邮政8 010（2 922）;护士支助8 131（3 228）。与对照组相比，两个干预组的PA均增加;邮政支持组每天增加642步（95% CI 329-955），护士支持组每天增加677步（95% CI 365-989）;邮政支持组每周增加33步（95% CI 17-49），护士支持组每天增加35步（95% CI 19-51）。在12个月时，两种干预措施之间无显著差异。10%（1,023/10,467）的招聘率是一个研究limitation.ConclusionsA主要是不活跃的45至75岁的老年人的初级保健计步器为基础的步行干预增加步数约十分之一，MVPA的时间约三分之一的较量。护士和邮政分娩取得了相似的12个月PA的结果。通过邮寄或提供最少支持的初级保健计步器干预可以帮助解决公共卫生身体活动不足的挑战。
BackgroundPedometers can increase walking and moderate-to-vigorous physical activity (MVPA) levels, but their effectiveness with or without support has not been rigorously evaluated. We assessed the effectiveness of a pedometer-based walking intervention in predominantly inactive adults, delivered by post or through primary care nurse-supported physical activity (PA) consultations.Methods and FindingsA parallel three-arm cluster randomised trial was randomised by household, with 12-mo follow-up, in seven London, United Kingdom, primary care practices. Eleven thousand fifteen randomly selected patients aged 45-75 y without PA contraindications were invited. Five hundred forty-eight self-reporting achieving PA guidelines were excluded. One thousand twenty-three people from 922 households were randomised between 2012-2013 to one of the following groups: usual care (n = 338); postal pedometer intervention (n = 339); and nurse-supported pedometer intervention (n = 346). Of these, 956 participants (93%) provided outcome data (usual care n = 323, postal n = 312, nurse-supported n = 321). Both intervention groups received pedometers, 12-wk walking programmes, and PA diaries. The nurse group was offered three PA consultations. Primary and main secondary outcomes were changes from baseline to 12 mo in average daily step-counts and time in MVPA (in >= 10-min bouts), respectively, measured objectively by accelerometry. Only statisticians were masked to group. Analysis was by intention-to-treat. Average baseline daily step-count was 7,479 (standard deviation [s.d.] 2,671), and average time in MVPA bouts was 94 (s.d. 102) min/wk. At 12 mo, mean steps/d, with s.d. in parentheses, were as follows: control 7,246 (2,671); postal 8,010 (2,922); and nurse support 8,131 (3,228). PA increased in both intervention groups compared with the control group; additional steps/d were 642 for postal (95% CI 329-955) and 677 for nurse support (95% CI 365-989); additional MVPA in bouts (min/wk) were 33 for postal (95% CI 17-49) and 35 for nurse support (95% CI 19-51). There were no significant differences between the two interventions at 12 mo. The 10% (1,023/10,467) recruitment rate was a study limitation.ConclusionsA primary care pedometer-based walking intervention in predominantly inactive 45- to 75-y-olds increased step-counts by about one-tenth and time in MVPA in bouts by about one-third. Nurse and postal delivery achieved similar 12-mo PA outcomes. A primary care pedometer intervention delivered by post or with minimal support could help address the public health physical inactivity challenge.